Active NPI
Kathleen B Stutz, M.D.
- Pediatrics Physician
- Vincennes, IN
National Provider Identifier
1962571463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R2F43
- Practice address
- 520 S 7TH St
Vincennes, IN 47591-1038 - Phone
- (812) 882-5220
- Fax
- (812) 885-3769
- NPI assigned
- Nov 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R2F43 | MO | Primary |
Addresses
Primary practice location
520 S 7TH St
Vincennes, IN 47591-1038
Mailing address
520 S 7TH St
Vincennes, IN 47591-1038
Phone (812) 885-3770
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200943340 | Medicaid | IN | |
| 208211813 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R2F43 | MO | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555459200000",
"number": "1962571463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 S 7TH ST",
"city": "VINCENNES",
"state": "IN",
"postal_code": "475911038",
"telephone_number": "812-885-3770",
"fax_number": "812-885-3769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 S 7TH ST",
"city": "VINCENNES",
"state": "IN",
"postal_code": "475911038",
"telephone_number": "812-882-5220",
"fax_number": "812-885-3769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUTZ",
"first_name": "KATHLEEN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-07",
"last_updated": "2019-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "R2F43",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200943340",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "208211813",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vincennes, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.